Provider Demographics
NPI:1033711445
Name:THE VISIONAIRE CARE GROUP
Entity Type:Organization
Organization Name:THE VISIONAIRE CARE GROUP
Other - Org Name:TRANSFORMING PAIN AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYSHONE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIRTLE
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:702-581-4711
Mailing Address - Street 1:2900 N GREEN VALLEY PKWY STE 114
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0408
Mailing Address - Country:US
Mailing Address - Phone:702-512-5800
Mailing Address - Fax:
Practice Address - Street 1:2900 N GREEN VALLEY PKWY STE 114
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0408
Practice Address - Country:US
Practice Address - Phone:702-581-4711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty